2680

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Submission Number
2680
Participant
Australian Nursing & Midwifery Federation
Submission date
Main Submission Automated Transcript

Australian Nursing and Midwifery Federation

SUBMISSION TO NATIONAL
VOICE CONSULTATION

30 APRIL 2021
Annie Butler
Federal Secretary

Lori-Anne Sharp
Assistant Federal Secretary

Australian Nursing and Midwifery Federation
Level 1, 365 Queen Street, Melbourne VIC 3000
T: 03 9602 8500
F: 03 9602 8567
E: anmffederal@anmf.org.au
W: www.anmf.org.au

2
Australian Nursing and Midwifery Federation / Submission to National Voice Consultation (April 2021)

INTRODUCTION
The Australian Nursing and Midwifery Federation (ANMF) is Australia’s largest national union and
professional nursing and midwifery organisation. In collaboration with the ANMF’s eight state and territory
branches, we represent the professional, industrial and political interests of more than 300,000 nurses,
midwives and carers across the country.

Our members work in the public and private health, aged care and disability sectors across a wide variety
of urban, rural and remote locations. We work with them to improve their ability to deliver safe and best
practice care in each and every one of these settings, fulfil their professional goals and achieve a healthy
work/life balance.

Our strong and growing membership and integrated role as both a professional and industrial organisation
provide us with a complete understanding of all aspects of the nursing and midwifery professions and see
us uniquely placed to defend and advance our professions.

Through our work with members, we aim to strengthen the contribution of nursing and midwifery to
improving Australia’s health and aged care systems, and the health of our national and global communities.

NATIONAL VOICE CONSULTATION
Aboriginal and Torres Strait Islander/First Nations people have never ceded sovereignty to this land. They
have lived and continue to live under the conditions of colonisation, enduring the theft and destruction
of lands, forced separation of children from families, generational trauma, inadequate compensation for
labour, excessive incarceration and deaths in custody, denial of rights to language and culture, inequitable
access to resources other Australians enjoy, and the structural, overt and casual racism inflicted by the
dominant white culture, and, ultimately a reduced life expectancy.

We welcome the opportunity to participate in the National Voice consultation. The ANMF recognises
and acknowledges the injustices that have taken and continue to take place, and it is our motivation and
desire that Australia can progress towards a just, respectful, culturally safe and inclusive relationship with
Aboriginal and Torres Strait Islander people. Australia’s First Nations people are the world’s oldest living
culture, and there is much for us to learn from them about this land we live on. We want the National Voice
initiative, along with constitutional recognition, to provide the way forward.

3
Australian Nursing and Midwifery Federation / Submission to National Voice Consultation (April 2021)

ANMF RECONCILIATION ACTION PLAN (RAP)
The ANMF has had a RAP since 2009, which guides our work and relationships with Aboriginal and Torres
Strait Islander organisations and people. As part of our RAP, we have policies on how ANMF consults with
Aboriginal and Torres Strait Islander organisations, health, and cultural awareness and safety. The overriding
principles reflected in our policies are those of self-determination, respect, partnership, and equity of
access to the resources that support good health and wellbeing. The ANMF regularly participates in Close
the Gap Day and National Reconciliation Week, and our RAP is a guiding document for our response to this
consultation.

Our RAP Working Group includes the role of an Aboriginal nurse adviser. She is a practicing registered nurse
in a clinical setting who participates in our working group, shares her networks with us and provides us with
guidance, advice and an Aboriginal perspective on issues that arise.

CLOSE THE GAP CAMPAIGN
The Close the Gap (CTG) Campaign was launched with both shame and optimism in 2007. In 2008, our
governments committed to closing identified gaps in educational attainment, health status, infant mortality,
life expectancy and employment between Aboriginal and Torres Strait Islander peoples and non-Indigenous
Australians.

In 2021, many of the gaps remain large, which is a national disgrace. The reasons for failure are closely
linked to the approach taken, which remains largely paternalistic and not founded in partnership, respect,
truth telling or understanding. It includes a short-term funding outlook and cuts to Aboriginal and Torres
Strait Islander health and wellbeing programs, creating uncertainty around the continuation of successful
community-led programs.

Add to that punitive policies which are contrary to CTG objectives, such as the imposition of the cashless
welfare card, high rates of incarceration, and high suicide rates for young Indigenous people and it is clear
that something is very wrong - not with Aboriginal and Torres Strait Islander people, but with the attitudes
and approaches of non-Indigenous Australia.

The Close the Gap Report for 2021 took a new approach in its focus, highlighting among other things
the successful management of COVID-19 by Aboriginal and Torres Strait Islander organisations and
communities, and Indigenous ways of tackling climate change. It emphasises a strengths-based approach
that focuses on success and what works in communities, rather than a deficit approach, which casts First
Nations people and communities as the problem. Promisingly, in 2020 an historic national agreement was
signed by Australian governments and Aboriginal and Torres Strait Islander peak organisations that commits
governments to a respectful partnership approach in achieving CTG objectives1.

The ANMF believes the proposal for a National Voice is entirely consistent with the objectives of the CTG
Campaign and the new National Agreement, providing a formalised, co-designed structure to facilitate
consultation on laws and policies that affect Aboriginal and Torres Strait Islander communities and
individuals.
1
National Agreement on Closing the Gap: An agreement between the Coalition of Aboriginal and Torres Strait Islander Peak Organisations and all
Australian Governments. July 2020. Available at https://www.closingthegap.gov.au/sites/default/files/2021-03/national-a…

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Australian Nursing and Midwifery Federation / Submission to National Voice Consultation (April 2021)

ABORIGINAL AND TORRES STRAIT ISLANDER
WORKFORCE
The Council of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM) has worked hard over
many years to attract and retain First Nations people into the nursing and midwifery professions. Recent
workforce data reflects some success2:

Between 2016 and 2019, the total number of Aboriginal and Torres Strait Islander nurses and
midwives with general or provisional registration increased by 37.0% from 3,677 to 5,037 (a
compound annual growth rate of 11.1%). The number of employed Aboriginal and Torres Strait
Islander nurses and midwives ('workforce') increased 36.4% from 3,202 to 4,369 over the same period
(a compound annual growth rate of 10.9%).

The number of Aboriginal and Torres Strait Islander nurse and midwives working in clinical settings has
increased 41.4%, from 2,838 to 4.012 over the same period.

The draft National Aboriginal and Torres Strait Islander health workforce strategic framework and
implementation plan 2021-2031 says that Aboriginal and Torres Strait Islander people are under-
represented in the health workforce3. In 2016, they represented only 1.8% of the health workforce,
while comprising 3.3% of the Australian population. To reach population parity, they have set a target for
Aboriginal and Torres Strait Islander people to represent 3.43% of the national workforce by 2031.

The ANMF understands that more Aboriginal and Torres Strait Islander nurses and midwives are necessary
for the provision of culturally safe healthcare and better health outcomes for First Nations people, and
ultimately a step towards closing the gap in life expectancy.

CONSTITUTIONAL RECOGNITION
The Close the Gap Report 2021 calls for the full implementation of the Uluru Statement from the Heart and
a constitutionally enshrined First Nations Voice4. The ANMF understands that the Uluru Statement from
the Heart and constitutional recognition are outside the scope of the National Voice proposal as it stands.5
However we believe it is important to be on the record on this matter.

The ANMF prefaces its comments on the National Voice proposal with the view that ultimately the two
processes – constitutional recognition and the establishment of the National Voice structures, should go
together as expressed in the CTG Report.

Constitutional recognition should underpin and provide a secure basis for the National Voice, whereby it
would not be subject to the whims of future governments. Enabling legislation for the National Voice must
be passed after a referendum has been held in the next term of Parliament.

2
Australian Institute of Health and Welfare (2020). Aboriginal and Torres Strait Islander nurses and midwives 2019. Canberra: AIHW.
3
National Aboriginal and Torres Strait Islander Health Workforce Project Reference Group [2020]. National Aboriginal and Torres Strait Islander health
workforce strategic framework and implementation plan 2021-2031.
4
Lowitja Institute (2021). Leadership and legacy through crises: Keeping our Mob safe - Close the Gap Campaign report 2021. Close the Gap Campaign
Steering Committee, p 6. Available at https://humanrights.gov.au/our-work/aboriginal-and-torres-strait-island…-
gap-2021
5
National Indigenous Australians Agency (2020). Indigenous Voice co-design process interim report to the Australian Government. Commonwealth of
Australia, p 177. Available at https://voice.niaa.gov.au/resources
5
Australian Nursing and Midwifery Federation / Submission to National Voice Consultation (April 2021)

Australia has a long history of calls for and promises of constitutional recognition. Calls and petitions by
Aboriginal and Torres Strait Islander people date back to early days of colonisation, Australian federation
and the time of the 1967 referendum6. Constitutional recognition has been promised most notably by John
Howard in 2007 and again by Julia Gillard in 20117. In 2021, constitutional recognition has still not been
achieved, and this too is a national shame.

The ANMF supports constitutional recognition as has been expressed by the Uluru Statement from the
Heart, which specifically states:

We seek constitutional reforms to empower our people and take a
rightful place in our own country. When we have power over our destiny
our children will flourish. They will walk in two worlds and their culture
will be a gift to their country.
We call for the establishment of a First Nations Voice enshrined in the
Constitution.8

AN INDIGENOUS VOICE
Aboriginal and Torres Strait Islander communities and individuals have fought hard to be heard, and have
delivered consistent messages around self-determination and a partnership, strengths-based approach.
They have shown tenacity, thoroughness, patience and wisdom in articulating the respectful, consultative
style of relationship they wish to build with non-Indigenous Australia. They know what they need to recover
and to thrive.

There have been proposals over many years for a formalised body through which to consult about laws
and policy which affect Aboriginal and Torres Strait Islander people, most recently the 2018 Joint Select
Committee on Constitutional Recognition.9 The Indigenous Voice proposal comes out of that work.

The ANMF supports an Indigenous Voice, however as already stated it should be implemented with
the principles of the Uluru Statement from the Heart in mind, including constitutional reforms. The
ANMF believes that if Australian governments are to take seriously their commitments to closing health,
education, employment and life expectancy gaps, and repairing relationships with Aboriginal and Torres
Strait Islander communities and people, and to engender trust by those communities, they must respond
positively to this proposal now. Australia cannot continue to be dismissive of Aboriginal and Torres Strait
Islander voices at the government level.

The ANMF strongly supports the broader Indigenous Voice proposal and the specific proposals for Local
and Regional Voices and a National Voice for Aboriginal and Torres Strait Islander people to parliament.
Government policies have been established at national and state/territory levels about the ways Aboriginal
and Torres Strait Islander people may exist, but have failed to consider their views about how they wish
to live. An Indigenous Voice will provide a way to ensure there is trusted, genuine consultation and a
collaborative approach.
6
Uluru Statement from the Heart (2017). https://ulurustatement.org/the-statement
7
Noel Pearson speech. National Museum of Australia, 17 March 2021. Available at https://www.youtube.com/watch?v=Q_T1lcF93Ds.
8
Op cit. Uluru Statement.
9
Joint Select Committee on Constitutional Recognition relating to Aboriginal and Torres Strait Islander Peoples. (2018). Final report. Canberra:
Commonwealth of Australia.
6
Australian Nursing and Midwifery Federation / Submission to National Voice Consultation (April 2021)

LOCAL AND REGIONAL VOICES
The ANMF supports the proposal as outlined in the Indigenous Voice Co-design discussion paper10 and the
Principles outlined in the Interim Report.11 Local and Regional Voices would be focused on their defined
areas, be properly resourced, and provide a trusted, inclusive forum for local Aboriginal and Torres Strait
Islander people, communities and organisations to express views and collaborate on community-led
initiatives and problem solving.

They may also provide a forum for consulting with non-Indigenous people and organisations. For example,
the ANMF has Branches in each state and territory, which is where our members join. ANMF Branches
are at various stages of developing Reconciliation Action Plans, which provide a foundation for work and
activism in Aboriginal and Torres Strait Islander matters. ANMF branches such as the QNMU have started
First Nations Reference Groups, which clearly endorse the Uluru Statement from the Heart.12 Local and
Regional Voice bodies could provide avenues for our Branches to engage and consult on local activities and
matters arising from their RAPs.

NATIONAL VOICE
The ANMF supports the National Voice proposal, however again reiterates that this must go ahead with
constitutional reform as clearly spelled out in the Uluru Statement from the Heart.

OPTIONS FOR MEMBERSHIP OF THE NATIONAL VOICE
The ANMF fundamentally supports the proposal that members of the National Voice are chosen by
Aboriginal and Torres Strait Islander people, structurally linked and drawn from within their communities
and from within the Local and Regional Voices, as described in Core model 1 of the Interim Report13.

The membership model for the National Voice should ensure previously unheard Aboriginal and Torres
Strait Islander people have the same chance of being selected as established leadership figures. Concerning
the length of term, the ANMF supports four years with staggered terms, for reasons of continuity and
stability, which can be achieved by overlapping terms.

10
National Indigenous Australians Agency (2021). Indigenous Voice: Discussion paper, pp 4-5. Available at https://voice.niaa.gov.au/resources
11
Op cit. Indigenous Voice co-design process interim report, pp 73-83.
12
Queensland Nurses and Midwives’ Union. QNMU takes home NAIDOC Union Award. 11 December 2020. Available at https://www.qnmu.org.au/
QNMU/PUBLIC/MEDIA_AND_PUBLICATIONS/News_items/2020/QNMU_NAIDOC_award_101220.aspx
13
Op cit. Indigenous Voice co-design process interim report, pp 35-36.
7
Australian Nursing and Midwifery Federation / Submission to National Voice Consultation (April 2021)

CONCLUSION
Australia is a country yet to reconcile with its past. Many non-Indigenous Australians, both individually and
organisationally, continue to exhibit racist responses in dialogues about the realities of our colonial past and
present activities.

The ANMF acknowledges and congratulates everyone who has worked hard on the National Voice process.
However, we believe it is important to note that the legislative route for a National Voice is fraught. The
legislation which governed the Aboriginal and Torres Strait Island Commission (ATSIC) was constantly
amended and the ANMF fears that any legislated outcome of this process risks having the same problems.

Having come to a model for the National Voice that is widely supported by the Aboriginal and Torres Strait
Islander community then this should be used as the basis for a referendum rather than going down the
legislative route. The Commonwealth government must honour its election commitment to a referendum
once a model for the National Voice has been settled.

8